Education and debate

Apgar scores for dads

Howard J Bennett, paediatrician. 

9 Avalon Court, Bethesda, MD 20816, USA

bennett{at}pop.dn.net

Fathers become anxious during labour and delivery.¹ This is especially true for first time dads, who have been observed shouting expletives at anyone wearing booties and a face mask. In the past no one quantified this stress or proposed effective ways to help nervous fathers to be. After years of unfunded research, I have come up with a scoring system like the one Virginia Apgar developed 45 years ago.² My test is performed in the same way as the traditional Apgar score, only in this case the examiner pays attention to the father instead of the baby (not a bad idea since dads are woefully underevaluated during the entire birthing process).

Apgar scores for dads (ASDs) are assigned right before delivery and at 1 minute after birth. The father is evaluated in the delivery room based on five easily determined signs (table). The first score is a guide to the father's wellbeing and tells practitioners how likely it is that (a) they will be knocked out or (b) they will have to resuscitate an 85 kg adult on a cold linoleum floor. The second score tests the dad's resiliency and lets the practitioner know how well he is adjusting to his new role as a parent. (I am currently investigating the long term implications of a high 1 minute score. It's too soon to tell, however, whether a high score predicts that a dad will help change nappies or eagerly wake up at 3 am to feed a hungry baby.)

	How to interpret the score

A score of 10 indicates that the dad is in the best possible condition and will, in all likelihood, not only thank you profusely but donate large sums of money to your favourite charity.

A score of 7 to 9 shows that the dad is still in pretty good shape and that a lawsuit is not very likely. The parents will probably say nice things about you at parties and family gatherings, even if they do make remarks about your not coming to the labour room often enough to check the epidural or refill the water jug.

A score of 4 to 6 indicates that the dad needs some medical attention. In many cases, this score results from his partner having a stranglehold on his neck. A strong nurse should be able to extricate the dad in between contractions and his score will improve accordingly. In other situations, tactile stimulation and a little blowby oxygen should do the trick. One classic approach is a quick slap on the cheek accompanied by the statement, "Snap out of it man, you're about to become a father." Be careful about letting a dad with a score less than 7 cut the cord because he'll probably take off one of your fingers instead.

A score of 1 to 3 indicates that things are pretty dicey. Valium, smelling salts, and intravenous Coca-Cola have all been used successfully in this situation.³ In many cases, however, all that's required is to prop the dad in an easy chair and let him watch videos of situation comedies from the 1950s. Back then all men had to do was sit in the waiting room until their little bundle arrived, all clean and snug, in the nurse's loving arms.

	Conclusion

When used as suggested, Apgar scores for dads will help clinicians manage the most neglected member of the family unit. Dads will appreciate the attention and, if you do a good job, they might even name one of their pets after you.

	Acknowledgments

HJB is editor of The Best of Medical Humour: a Collection of Articles, Essays, Poetry, and Letters Published in the Medical Literature. Philadelphia: Hanley and Belfus, 1997.

	References

1. Randolph D. Controversies in cord clamping: catch the baby or catch the dad? Arch Uterus 1996; 43: 127-129.
2. Apgar V. A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg 1953; 32: 260-264.
3. Ferguson L. How to manage dads who faint in the DR. J Dubious Invest 1997; 39: 658-659.